Primary Prevention of Cardiovascular Diseases in General Practice: Mismatch between Cardiovascular Risk and Patients' Risk Perceptions

Medical Decision Making - Tập 27 Số 6 - Trang 754-761 - 2007
Trudy van der Weijden1, Ben van Steenkiste1, Jelle Stoffers1, Daniëlle R. M. Timmermans2, Richard Grol1
1Department of General Practice/Centre for Quality of Care Research (WOK), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands,
2Department of Social Medicine, VU University Medical Centre, Amsterdam, The Netherlands

Tóm tắt

Objective. Guidelines on primary prevention of cardiovascular disease (CVD) emphasize identifying high-risk patients for more intensive management, but patients' misconceptions of risk hamper implementation. Insight is needed into the type of patients that general practitioners (GPs) encounter in their cardiovascular prevention activities. How appropriate are the risk perceptions and worries of patients with whom GPs discuss CVD risks? What determines inappropriate risk perception? Method. Cross-sectional study in 34 general practices. The study included patients aged 40 to 70 years with whom CVD risk was discussed during consultation. After the consultation, the GPs completed a registration form, and patients completed a questionnaire. Correlations between patients' actual CVD risk and risk perceptions were analyzed. Results. In total, 490 patients were included. In 17% of the consultations, patients were actually at high risk. Risk was perceived inappropriately by nearly 4 in 5 high-risk patients (incorrect optimism) and by 1 in 5 low-risk patients (incorrect pessimism). Smoking, hypertension, and obesity were determinants of perceiving CVD risk as high, whereas surprisingly, diabetic patients did not report any anxiety about their CVD risk. Men were more likely to perceive their CVD risk inappropriately than women. Conclusion. In communicating CVD risk, GPs must be aware that they mostly encounter low-risk patients and that the perceived risk and worry do not necessarily correspond with the actual risk. Incorrect perceptions of CVD risk among men and patients with diabetes were striking.

Từ khóa


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Thông tin
Thông tin xuất bản

Medical Decision Making

Tập 27 Số 6

754-761

Thông tin tác giả